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5th East Asia Joint Symposium on Plasma and Electrostatic Technologies for
Environmental Application (EAPETEA-5)
June 9-11, 2017, Dalian, China
Pre-registration form
REGISTRATION INFORMATION-please fill in the form clearly and ensure the accuracy of the mailing address
Title:
□Dr.
Last (Family) Name:
Nationality:
Institute/Company:
Postal Address:
Postal Code:
Email:
□Mr.
□Ms.
□Miss
First (Given) Name:
Tel:
□Prof.
Fax:
ACCOMPANYING MEMBERS’ INFORMATION
Title:
□Dr.
Last (Family) Name:
Nationality:
□Mr.
□Ms.
□Miss
First (Given) Name:
PAPER INFORMATION:
Working title:
Topic (select from the list on
website of EAPETEA-5)
Conference presentation
Oral
Poster
Please email the pre-registration form to us before December 31st, 2016.
Our email address is [email protected]
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